Credit Card Authorization
**Please note gift certificates can also be purchased
The Ridge at Castle Pines
1414 Castle Pines Pkwy.
Castle Rock, CO 80108
(303) 688-4301 phone
(303) 688-0128 fax
Card Holder Information: (Please Print)
Name: Phone: _____________________
Address: ___________________________________________
Card Type: Visa/ Master Card/ American Express
Card Number: _______________________________________ Expiration:_____________________
ITEMS TO BE PURCHASED:
( ) Gift Certificate: Dollar Value: $
(Please fill in blanks for gift certificate)
TO:____________________________________________________
FROM:_________________________________________________
FOR:___________________________________________________
VALUE:_________________________________________________
( ) Green Fees: # of Rnds.: Fees w/Tax: $_____________
( ) Other:__________________________________________
( ) Please mail/ship my certificate for an additional $3.00 charge
( ) Please overnight my certificate and charge my card $15.00 for domestic overnight service
ITEMS TO BE SHIPPED TO: (If different than above information)
Name: __________________________________
Address: _______________________________
________________________
( ) Please hold my item and call me when it is ready for pick up
Phone number: _______________________________________
I authorize The Ridge at Castle Pines North to charge above credit card for the total amount due:
Name on Card (please print)______________________________ Amount $:____________________
Signature: ____________________________________________ Date:________________________
Photo Copy of Front of Credit Card Photo Copy of Back of Credit Card
Photo Copy of Front of Drivers License
PLEASE RETURN VIA FAX TO (303) 688-0128
Please make sure to check Pro Shop Hours to ensure your request is received. | 
